化学中毒患者心理评估及血浆氨基酸测定

目的评估化学中毒患者心理状态并检测血浆氨基酸水平变化。方法选择解放军第三〇七医院2012年12月收治的中毒患者34例,采用液质联用（LC-MS/MS Q-TRAP）同位素内标法,测定患者的血浆全谱氨基酸,用秩和检验对牛磺酸（Taurine,Tau）、甘氨酸（Gly）、谷氨酸（Glu）、γ-氨基丁酸（GABA）、天门冬氨酸（Asp）、丙氨酸（Ala）水平,并与标准值进行比较;对患者相关心理测试做出评估。结果中毒患者Tau和Glu水平高于标准值（氨基酸正常上下限的平均值）,Gly和GABA的水平低于标准值,差异均有统计学意义（P〈0.05）;Asp、Ala水平与标准值比较,差异均无统计学意义（P〉0.05）;心理测试表明34例患者多数存在明显的焦虑和睡眠障碍。结论血中氨基酸水平变化可用来推断中毒患者的心理问题;氨基酸的变化趋势与心理问题有关。

Psychological assessment and plasma amino acid determination of chemical poisoning patients

Objective To estimate the psychological states and plasma amino acid content in chemical poisoning pa tients.Methods 34 patients of chemical poisoning in December 2012 in the 307th hospital of PLA were selected.The liquid chromatography-mass spectrometry（LC-MS/MS Q-TRAP） isotope internal standard method was used to deter mine the full spectrum of plasma amino acids of the 34 chemical poisoning patients.The contrast among the level of Taurine（Tau）,glycine（Gly）,glutamic acid（Glu）,γ-aminobutyric acid（GABA）,aspartic acid（Asp）,alanine（Ala） and the standard values were analyzed by the rank sum test.The psychological assessment was made based on the relevant psychological tests.Results The Tau and Gly levels of chemical poisoning patients were higher than their standard val ues（the average of normal upper and lower limits of the amino acid）,Glu and GABA levels were lower than their standard values,the differences were statistically significant（P ＆lt; 0.05）;the differences between Asp and Ala levels and their standard values were not statistically significant（P ＆gt; 0.05）;the majority of the 34 patients with ignificant anxiety and sleep disorders were found.Conclusion The psychological tests conducted during hospitalization show that most patients suffer from significant anxiety and severe sleep disorders.The patients’ psychological situation is corre lated with the changes of plasma amino acid.